STEPP is a forerunner of the BMWGP Trial. The STEPP study has been completed. The study aimed to explore the feasibility of enhancing preventive care for patients with low health literacy in Australian primary care. The study was conducted in four general practices in disadvantaged communities in Sydney. The intervention included screening of patients in general practice for their level of health literacy, training of GPs and PNs in communication techniques with patients of low health literacy, and follow up visits to review an audit of medical records of preventive care and facilitate appropriate referral.

The study found that between one eighth and a half of patients screened reported insufficient levels of health literacy. Clinicians accepted the importance of providing preventive care as part of their routine care, but they expressed frustration at their ability to facilitate lifestyle change among some disadvantaged patients. Recording of preventive care especially BMI and waist circumference improved in all practices and there were fewer obese patients in two practices at follow up. Clinicians reported an increased frequency of tailoring advice, asking patients to repeat key points and encouraging questions from patients with low health literacy. However there was less change in their overall approach to preventive care. It may be more effective to tailor education and support to these different approaches.